Common Questions TGA approved CGRP Blocking Injection therapy

What is CGRP?

Calcitonin gene related peptide (CGRP) is a neuropeptide associated with the development of migraine. It is felt to be involved in dilation of cerebral blood vessels, release of inflammation and transmission of nervous system pain pathways

What happens to CGRP levels during a migraine?

CGRP levels have been shown to increase significantly during a migraine and return to normal with migraine relief.

What is the new TGA approved therapy for migraines?

The therapy is a 100% human monoclonal antibody that blocks the activation of the CGRP receptor. The medication has been developed specifically for the prophylaxis of migraine in adults.

When will this CGRP targeting drug be available?

Whilst this drug has been TGA approved, it is not currently available on the PBS. There is however the availability of a 3 month trial of the medication, with the option, in the event of beneficial effect, of purchasing ongoing supply privately. Suitability criteria do apply however, and a Neurological assessment is required to assess for eligibility.

Common Questions PBS approved Nerve blocking therapy

What is the active ingredient in PBS approved Nerve blocking therapy?

The active ingredient is an injectable protein produced by a bacterium (Clostridium botulinum) that paralyzes muscles into which it is injected

How does injection therapy work for migraines?

Injection therapy is believed to work for migraine by blocking pain signalling transmission between the head and neck and the central brain where migraine is generated.

Will injection therapy cure my migraines?

No, injection therapy is not a cure for migraines, it does however represent an effective preventative intervention in many migraine patients. When it works for chronic migraine, the results can be dramatic, not just in reducing headache days but with significant improvement in headache related quality of life assessments.

Common Questions ONBs

What are Occipital nerve blocks (ONBs) used for?

ONBs may treat a variety of headache disorders and have varying indications. The most common indications include:

Treating an acute migraine attack for rescue purposes

Rapidly suppressing an attack period in cluster headache

Weaning patients with medication overuse off of acute pain medications while prophylactic medications are initiated or escalated

Repeating ONBs in the treatment of chronic daily headache

What does the procedure involve?

The procedure typically takes only a few minutes, and patients should have no problem driving afterwards and carrying on with their day. A small needle is used to inject a solution into the area around the nerves. The composition of the solution contains a local anaesthetic drug and a steroid anti-inflammatory drug. Pain relief can occur within 15 minutes of the block. For those who experience relief, the duration of the therapeutic response varies widely; for days, weeks or even months.

What are the side effects?

Occipital nerve blocks are safe and well tolerated, and complications are quite rare. Most patients experience head numbness in the distribution of the injected nerve branches. Localised symptoms such as pain or haematoma may occur. Dizziness or blood pressure alterations may occur uncommonly, but are transient. Allergic reactions to local anaesthetic have been described but are rare. Corticosteroid injections may be associated with both local and systemic adverse effects, and these potential issues will be advised in more detail by the administering doctor.